Knee Research Articles

Effect of External Work Magnitude on Mechanical Efficiency of Sledge Jumping.

The mechanical efficiency of human locomotion has been studied extensively. The mechanical efficiency of the whole body occasionally exceeds muscle efficiency during bouncing type gaits. It is thought to occur due to elasticity and stiffness of the tendinomuscular system and neuromuscular functions, especially stretch reflexes. In addition, the lower limb joint kinetics affect mechanical efficiency. We investigated the impact of varying external work on mechanical efficiency and lower limb kinetics during repeated sledge jumping. Fifteen male runners performed sledge jumping for 4minutes at 3 different sledge inclinations. Lower limb kinematics, ground reaction forces, and expired gases were analyzed. Mechanical efficiency did not differ according to sledge inclination. Mechanical efficiency correlated positively with the positive mechanical work of the knee and hip joints and the negative contribution of the hip joints. Conversely, it correlated negatively with both the positive and negative contributions of the ankle joint. This may be attributable to the greater workload in this study versus previous studies. To achieve greater external work, producing more mechanical energy at the proximal joint and transferring it to the distal joint could be an effective strategy for improving mechanical efficiency because of the greater force-generating capability of distal joint muscles.

Age and initial position affect movement biomechanics in sit to walk Transitions: Lower limb muscle Activity and joint moments

Facilitating forward movement while maintaining dynamic stability during transitions like sit-to-walk (STW) requires coordination from many muscles. Age-related muscle, sensory, and neural decline can introduce compensatory biomechanics when completing STW, such as adjusting initial foot position or rising with arm support. Many previous STW studies restrict arm movement and prescribe symmetric foot positions, therefore the purpose of this study was to quantify lower limb muscle excitations and joint moments in STW transitions from four initial foot positions [symmetric, posterior offset, wide, narrow] and two arm placements [hands on knees, arms folded] in 15 younger and 15 older adults. Peak knee and ankle joint extension moments, as well as peak electromyography of five bilateral lower-limb muscles were analyzed. In all conditions, older adults had larger knee extension moments, whereas younger adults had larger ankle plantarflexion moments. Older adults generated larger peak excitation from the knee extensor muscles during rising compared to younger adults, consistent with the higher knee extension moments. Older adults had greater peak dorsiflexor and plantarflexor muscle excitation while rising compared to younger adults. Posterior offset and wide foot positions required the largest peak ankle plantarflexion and knee extension moments and plantarflexor muscle excitation. Arm-supported rising decreased peak knee extensor muscle excitation. In addition, there were interaction effects between age and initial foot position/arm placement for multiple quantities, indicating that the effects of foot and arm placement vary with age. These results inform assessments of movement performance and guidelines for rising given individual lower limb capability.

AI-smartphone markerless motion capturing of hip, knee, and ankle joint kinematics during countermovement jumps.

Recently, AI-driven skeleton reconstruction tools that use multistage computer vision pipelines were designed to estimate 3D kinematics from 2D video sequences. In the present study, we validated a novel markerless, smartphone video-based artificial intelligence (AI) motion capture system for hip, knee, and ankle angles during countermovement jumps (CMJs). Eleven participants performed six CMJs. We used 2D videos created by a smartphone (Apple iPhone X, 4K, 60 fps) to create 24 different keypoints, which together built a full skeleton including joints and their connections. Body parts and skeletal keypoints were localized by calculating confidence maps using a multilevel convolutional neural network that integrated both spatial and temporal features. We calculated hip, knee, and ankle angles in the sagittal plane and compared it with the angles measured by a VICON system. We calculated the correlation between both method's angular progressions, mean squared error (MSE), mean average error (MAE), and the maximum and minimum angular error and run statistical parametric mapping (SPM) analysis. Pearson correlation coefficients (r) for hip, knee, and ankle angular progressions in the sagittal plane during the entire movement were 0.96, 0.99, and 0.87, respectively. SPM group-analysis revealed some significant differences only for ankle angular progression. MSE was below 5.7°, MAE was below 4.5°, and error for maximum amplitudes was below 3.2°. The smartphone AI motion capture system with the trained multistage computer vision pipeline was able to detect, especially hip and knee angles in the sagittal plane during CMJs with high precision from a frontal view only.

Analysis of the interplay between proximal lower limb and foot joint structures as a mechanical predictor of neuropathic ulceration

BackgroundDiabetes-related foot ulcers are a leading cause of morbidity and mortality globally, in which the most significant contributing factor is peripheral neuropathy. The purpose of this research was to evaluate the influence of diabetic peripheral neuropathy and ulceration on lower limb and foot joint kinematics during gait. Research questionAre there any significant alterations lower limb and foot joint kinematics during gait in the presence of active and history of diabetic neuropathic ulceration? MethodsA prospective, cross-sectional study was conducted, recruiting eighty adult participants who were equally divided into four groups, namely, the diabetes (DM), diabetic peripheral neuropathy (DPN), active diabetic neuropathic ulceration (DNU) and history of diabetic neuropathic ulceration (DHNU) groups. Three-dimensional gait analysis was performed, and participants were instructed to walk barefoot over a 10-m walkway at self-selected speed. The acquired pelvic, hip, knee, ankle and foot joint segmental kinematic data was compared between individuals with and without active neuropathic ulceration. ResultsMean scores between the four independent groups was performed using the Kruskal-Wallis test. Participants within the DNU and DHNU groups demonstrated significantly reduced knee flexion, ankle dorsiflexion and first metatarsal dorsiflexion kinematics with resultant increased anterior pelvic tilt, hip flexion and midtarsal kinematics (all values p<0.01) when compared to participants within the DM and DPN groups. SignificanceThrough the integration of a more individualised, biomechanical approach, the findings in this study may provide improved preventative and management strategies of ulceration amongst the diabetic population.

The Potential of Tendon Autograft as Meniscus substitution: Current concepts

Meniscectomy is known to alter the mechanics, stability, and kinematics of the tibiofemoral joint, leading to early knee osteoarthritis (KOA). While several meniscal substitutions exist, such as meniscus allograft transplantation, collagen meniscus implants, and artificial substitutes, they often come with technical challenges, high costs, and risks, including allograft failure, infections, and disease transmission. Tendon autografts emerge as a promising option, offering safety, availability, biocompatibility, and a reduced risk of pathophoresis.This review delves into basic, in vivo, in vitro, and biomechanical studies alongside clinical outcomes and future prospects of tendon autografts as meniscus substitutes. A thorough understanding of this option is vital for integrating these evolving techniques into clinical practice and mitigating early KOA progression.

Muscular Fatigue Influences Patellofemoral Joint Reaction Force During Cutting In Healthy Females

Muscular Fatigue Influences Patellofemoral Joint Reaction Force During Cutting In Healthy Females

Reliability and Validity of an Ultrasound-Derived Measure for Axial Patellofemoral Alignment

Background: Axial extensor mechanism alignment is routinely assessed in patients with patellofemoral instability.Although many of these assessments are described using magnetic resonance imaging, it is plausible that ultrasound (US) imaging could be utilized to provide similar information in a more cost-effective and time-efficient manner. Purpose: To (1) describe and assess the reliability of a novel measure of extensor mechanism alignment of the patellofemoral joint using musculoskeletal US and (2) establish the construct validity of this measure through comparison of patients with and without patellar instability. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Patients with (n = 24; 14.2 ± 3.1 years; 83% female) and without (n = 26; 14.7 ± 2.8 years; 69% female) a clinical history of patellofemoral instability (PFI) participated. Extensor mechanism alignment was assessed bilaterally on US, measuring the distance between the midpoint of the patellar tendon to the lateral trochlear ridge (MPT-LTR). Interrater reliability of the measurements was assessed using the intraclass correlation coefficient (ICC), with a minimum of 1 week between measurements for test-retest reliability. Differences between limbs were assessed using paired-samples t tests, and between-group differences were compared using independent-samples t tests. Results: Patients with PFI demonstrated a significantly smaller MPT-LTR distance than healthy controls on both their involved (8.1 ± 3.6 vs 12.6 ± 2.6 mm) and uninvolved (8.9 ± 3.4 vs 12.9 ± 2.4 mm) limbs ( P &lt; .001 for both), indicating greater lateralization of the patellar tendon relative to the trochlea. There were no differences found between limbs for either patients with PFI ( P = .26) or controls ( P = .46). Interrater reliability was good (ICC = 0.785; 95% confidence interval [CI], 0.579-0.890), and test-retest reliability (n = 8) was excellent (ICC = 0.958; 95% CI, 0.790-0.992). Conclusion: The US-based MPT-LTR distance demonstrated good-to-excellent reliability. When compared with controls, the MPT-LTR distance was smaller in patients with PFI, indicating greater lateralization of the extensor mechanism.

The effect of femoral strapping on hip internal rotation and pain response in females with patellofemoral pain

BackgroundHip internal rotation has been reported to affect patellofemoral joint mechanics and contribute to patellofemoral pain (PFP). The SERF (Stability through External Rotation of the Femur) strap was designed to provide hip stability by pulling the thigh into external rotation during weight-bearing activities. Research questionWhat are the effects of the SERF strap on hip internal rotation and pain response in females with PFP who present with hip internal rotation during weight-bearing activities? MethodsNineteen females between the ages of 18 and 45 with a diagnosis of PFP participated. Lower extremity kinematics were obtained during three tasks (drop-jump, unilateral step-down, over-ground running) under strap and no-strap conditions. A 10-cm visual analog scale (VAS) was used to assess pain response during each task and strap condition. Participants who exhibited at least 5 degrees of hip internal rotation during at least one of the 3 tasks were included in the final analysis. Peak hip internal rotation and mean VAS score were compared separately between strap conditions across tasks using 2 ×3 (strap condition x task) repeated-measures ANOVAs. ResultsEighteen of the 19 females with PFP met the criteria for the presence of hip internal rotation. There was a significant reduction in peak hip internal rotation across tasks when wearing the SERF strap (mean ± sd = 7.4 ± 2.3, p<0.001). Additionally, the change in mean VAS pain score was significantly lower across tasks when wearing the SERF strap (1.0 ± 1.0, p=0.03). SignificanceThe SERF strap was effective in reducing hip internal rotation and PFP during dynamic weight-bearing activities in symptomatic females. The SERF strap may be a useful treatment adjunct for persons with PFP who present with poor transverse plane control of the hip.

Effects of addition of hyaluronic acid on platelet rich plasma in treatment of chronic osteoarthritis of knee joints

Effects of addition of hyaluronic acid on platelet rich plasma in treatment of chronic osteoarthritis of knee joints

Hypervirulent Carbapenem-Susceptible Klebsiella pneumoniae ST412/K57 with Strong Biofilm Formation: association with gas gangrene and sepsis.

Hypervirulent Klebsiella pneumoniae (hvKp) poses a serious public health threat. Gas gangrene caused by hvKp was rarely reported, potentially resulting in a poor prognosis. In this study, we described the case of a hospitalized patient with gas gangrene and sepsis by hvKP. The carbapenem-susceptible hypervirulent Klebsiella pneumoniae (CS-hvKp) strains KPLSN and KPLSX were isolated from the knee joint pus and blood specimens of the patient for further investigations. Whole genome sequencing revealed that KPLSN and KPLSX were highly homologous (SNPs<10) and belonging to ST412/K57. The minimum inhibitory concentration and minimum bactericidal concentration under biofilm values of meropenem in KPLSN and KPLSX were significantly higher than planktonic state (>128 mg/L versus 0.25 mg/L, P<0.0001). These two strains had high biofilm formation ability, and fluorescence staining experiments results showed that they were not easily killed by meropenem in the biofilm state. KPLSN and KPLSX showed high capsular production and were confirmed with high virulence through experiments with the Galleria mellonella and BALB/c mice abdominal infection model. The persistent symptoms may be due to enhanced biofilm and capsule formation. Global ST412 strains phylogenetic analysis showed their evolution towards higher virulence and resistance. It emphasizes the critical need for judicious antibiotic use and novel therapeutic approaches to combat special infections caused by these pathogens.

Patterns of thermal normality of the knee joint in professional athletes of different sports

Patterns of thermal normality of the knee joint in professional athletes of different sports

Biomechanical Comparison of Suture-Relay All-Suture Anchors and Conventional Suture Anchors for Posterior Medial Meniscus Root Repair in Porcine Models.

Posterior medial meniscus root (PMMR) tears (PMMRTs) can be repaired using various techniques to promote healing. However, the biomechanical properties of suture-relay all-suture anchor (ASA) versus conventional suture anchor (CSA) and loop-locking transtibial pullout (TTP) have not been well established. To compare the biomechanical properties of PMMR repairs using suture-relay ASA, CSA, and loop-locking TTP. Controlled laboratory study. A total of 33 fresh-frozen porcine knee joints with intact medial menisci were randomly divided into 3 groups, with 11 specimens in each group: ASA, CSA, and TTP. The study involved cyclic loading, with displacement measurements taken after 100, 500, and 1000 cycles. Subsequently, the specimens were loaded until clinical failure (defined as 3-mm displacement) and then to ultimate failure of the construct, with data recorded for displacement after cyclic loading, load to 3-mm displacement, and ultimate load to failure. After 1000 cyclic loadings, the suture-relay ASA group showed considerably less displacement than the loop-locking TTP group (1.8 ± 0.7 mm vs 2.9 ± 0.3 mm; P < .001), but the displacements did not differ considerably between the suture-relay ASA and CSA groups (2.2 ± 0.9 mm; P > .05). The mean loads to clinical failure were significantly greater in the suture-relay ASA and CSA groups (61.3 ± 6.5 and 57.5 ± 9.7 N, respectively) than in the loop-locking TTP group (38.3 ± 9.4 N; P < .05). The ultimate load to failure was significantly greater in the suture-relay ASA group than in the loop-locking TTP group (153 ± 55.1 N vs 102 ± 12.9 N; P < .05). All specimens in the loop-locking TTP group failed by suture elongation mode, whereas only 2 specimens (18%) in the suture-relay ASA group and 5 specimens (45%) in the CSA group failed by suture elongation. Nine specimens (82%) in the suture-relay ASA group and 6 specimens (55%) in the CSA group failed due to suture cutout through the meniscal tissue. The biomechanical properties after PMMR repair did not statistically differ between the suture-relay ASA and CSA groups. The suture-relay ASA technique had a higher load to failure than the loop-locking TTP technique. The suture-relay ASA technique is a promising option for the repair of PMMRTs; its repairing strength is also comparable to that of the CSA technique. Notably, the suture-relay ASA technique can be utilized without establishing a posteromedial portal, resulting in decreased procedure time and mitigating challenges associated with working from the posterior aspect of the knee.

High-load strength training compared with standard care treatment in young adults with joint hypermobility and knee pain: study protocol for a randomised controlled trial (the HIPEr-Knee study)

IntroductionPatients with generalised joint hypermobility, including knee hypermobility (GJHk), often experience knee pain and are typically managed with low-intensity strength training and/or proprioceptive training as part of standard care. However,...

Relationship of Physical Factors to the Occurrence of Injuries in Young Gymnasts.

There is a large population of young athletes who participate in gymnastics, and the prevention of injury in junior athletes is considered important. However, few studies have prospectively investigated the relationship between physical factors and the occurrence of injury. To investigate the physical characteristics that are factors in the injury occurrence in elementary and junior high school gymnasts. Prospective observational study. A total of 36 healthy young gymnasts (at national competition level) were enrolled in the study. Once a week for 23 weeks, injuries were prospectively investigated using self-report questionnaires under the supervision of a research staff. Joint range of motion (hip, ankle, shoulder, and wrist), tightness (Thomas test, Ely test, straight leg raise [SLR], triceps surae, combined abduction test [CAT], horizontal flexion test [HFT]), and muscle elasticity (multifidus) were assessed to compare differences in physical function between injured and non-injured participants. Injuries occurred most commonly in the wrist (42.1%), lower back (30.2%), and foot (9.5%) among males, whereas heel (22.2%), knee (16.0%), and lower back (12.8%) were the most common injury sites among females. Wrist injuries in male athletes showed decreased shoulder joint range of motion, and lower back injuries showed decreased hip and shoulder joint range of motion. Lower back injuries in female athletes showed decreased hip extension mobility. Heel and knee joint injuries in females also showed increased range of motion and decreased tightness. The results of this study indicate that the factors related to flexibility differ according to injury location. Further studies are required to clarify the physical factors that influence injury occurrence by examining the effects of the gymnasts' muscle strength, age, individual factors, and left-right differences. 3.

Effects of increasing walking cadence on gait biomechanics in adults with knee osteoarthritis

Gait retraining is a strategy to manage altered loading patterns and pain characteristic of knee osteoarthritis. Lower walking cadence is associated with higher knee joint loading, vertical ground reaction forces, and risk for cartilage worsening. Therefore, we determined the acute effects of increasing walking cadence on measures of lower extremity loading and knee pain in knee osteoarthritis. Twenty-five participants with knee osteoarthritis (age = 62.5 ± 7.2; 76.0 % female) walked at fixed speed on an instrumented treadmill from which baseline cadence was measured. Five, randomized experimental cadence conditions (2 %, 4 %, 6 %, 8 %, or 10 % over baseline cadence) were completed. Real-time auditory and visual feedback on cadence was provided while kinematics and ground reaction forces were sampled. Linear mixed effects models evaluated the effect of cadence on knee adduction and flexion moment peaks and impulses, impact loading metrics (vertical ground reaction force impact peak, vertical average and instantaneous loading rates), and knee pain. Increasing cadence by 2–10 % did not significantly change knee adduction moment peaks or impulse. Peak knee flexion moment increased by 3–32 % and knee flexion moment impulse reduced by 2–9 % with increases in cadence, but these results were not significant (peak knee flexion moment, p = 0.070; knee flexion moment impulse, p = 0.085). Increasing cadence significantly increased the vertical impact peak (p < 0.001), and the vertical average (p = 0.010), and instantaneous (p = 0.007) loading rates. Small increases in cadence at a fixed gait speed does not significantly change surrogate measures of knee joint loading or pain, but does increase measures of impact loading.

Knee joint dysfunction in the patients immediately before arthroplasty was well reflected by locomotive syndrome, not physical frailty.

We assessed physical function by three different methods in patients with knee osteoarthritis just before total knee arthroplasty (TKA) and investigated the relationship between impairment of mobility and preoperative factors. All patients scheduled to undergo TKA at our hospital were assessed for basic attributes, clinical assessment, radiography, whole-body mode DXA, knee muscle strength. And frailty, sarcopenia, and locomotive syndrome (LS) were evaluated. Among 204 patients (213 knees),172 women, mean age 75.0 years, the overall distribution in frailty was <no: 14.6%, pre-frailty: 58.5%, and frailty: 26.8%>; in sarcopenia <no: 93.3%, yes: 3.4%, and severe: 3.4%>; and in LS <Stage 0: 0%, Stage 1: 3.3%, Stage 2: 11.4%, and stage 3: 85.3%>. Eighty-seven percent of the patients with frailty and 92% with LS stage 3 did not suffer from sarcopenia. Statistically significant relationships were observed between sarcopenia and frailty, while no relationship between LS and frailty or LS and sarcopenia. Multivariate analysis of related factors with severity level for frailty and LS revealed statistically significant correlations for frailty with gait speed and LS with KSS and muscle strength. In the patients with knee OA immediately before arthroplasty, physical frailty and LS was not related with by sarcopenia. Knee joint dysfunction without sarcopenia was well reflected by LS, not by physical frailty.

Effect of the menstrual cycle on knee joint position sense and dynamic balance

The objective of this study was to examine how the menstrual cycle affects knee joint position sense (JPS) and dynamic balance. Forty-five physically active women (age 20.87 ± 0.54 years) participated in this study. Pain was measured with a Visual Analogue Scale (VAS). Knee JPS was measured using the passive-active repositioning method using a digital inclinometer. The modified Star Excursion Balance Test was used to assess dynamic balance (SEBT). The VAS scores were higher in the menses phase compared to the mid-luteal phase (p < 0.001) and mid-follicular phase (p = 0.002). No significant differences were found between phases of the menstrual cycle for JPS in 30° (p > 0.05) and 60° of knee flexion (p > 0.05). There were significant differences in the anterior (p = 0.028), posteromedial (p < 0.001), and posterolateral (p < 0.001) directions of the modified SEBT. The values of the anterior direction in a mid-follicular phase were higher than the menses phase (p = 0.017). Mid-luteal phase values in the posteromedial direction were greater than mid-follicular phase (p = 0.008) and menses phase (p < 0.001). The values of the posterolateral direction in the mid-luteal phase (p < 0.001) and mid-follicular phase (p = 0.009) were higher than in the menses phase. In conclusion, the knee JPS did not change during the menstrual cycle in physically active women. However, the dynamic balance performance was at the lowest level in the menses phase. The risk of injury should be considered during menstruation, especially in activities that require dynamic balance skills in physically active women.

Protein folding dependence on selenoprotein M contributes to steady cartilage extracellular matrix repressing ferroptosis via PERK/ATF4/CHAC1 axis

ObjectiveInitiation of endoplasmic reticulum (ER) stress is pivotal to the advancement of osteoarthritis (OA). We aimed to explore the function of ER-resident selenoprotein M (SELM) in cartilage-forming chondrocytes, investigating how SELM participates in cartilage extracellular matrix (ECM) metabolism and ER stress modulation. MethodsArticular cartilage samples with knee OA undergoing total knee arthroplasty were categorized into OA-smooth and OA-damaged groups, with primary chondrocytes extracted from smooth areas. Destabilization of the medial meniscus was induced in male C57BL6/J mice, with sham operations on the left knee as controls. After 8 weeks, knee joint tissues were collected for analysis. Histology and immunohistochemistry examined cartilage damage. Molecular biology techniques investigated how SELM affects ECM metabolism and ER stress regulation. RNA sequencing revealed the pathway changes after SELM intervention. AlphaFold demonstrated how SELM interacts with other molecules. Cultured cartilage explants helped determine the effects of SELM supplementation. ResultsSELM expression was reduced in the damaged cartilage. Increasing SELM levels positively impacted ECM equilibrium. Decreasing SELM expression activated genes linked to degenerative ailments and impaired the cellular response to misfolded proteins, initiating the PERK/P-EIF2A/ATF4 pathway and exacerbating GSH/GSSG imbalance via the ATF4/CHAC1 axis. SELM likely participated in protein folding and modification by leveraging its thioredoxin domains. In vitro SELM supplementation mitigated IL-1β effects on damaged cartilage explants and suppressed beneficial chondrocyte phenotypes. ConclusionsOur results confirm the involvement of SELM in ER stress-induced cartilage damage as well as protein folding, pointing to new directions in molecular therapy for degenerative diseases.

Knee joint pathology and efferent pathway dysfunction: Mapping muscle inhibition from motor cortex to muscle force

BackgroundDysfunction in efferent pathways after knee pathology is tied to long-term impairments in quadriceps and hamstrings muscle performance, daily function, and health-related quality of life. Understanding the underlying etiology is crucial for effective treatment and prevention of poor outcomes, such as post-traumatic osteoarthritis or joint replacement. ObjectivesTo synthesize recent evidence of efferent pathway dysfunction (i.e., motor cortex, motor units) among individuals with knee pathology. DesignCommentary. MethodWe summarize the current literature investigating the motor cortex, corticospinal tract, and motoneuron pool in individuals with three common knee pathologies: anterior cruciate ligament (ACL) injury, anterior knee pain (AKP), and knee osteoarthritis (OA). To offer a complete perspective, we draw from studies applying a range of neuroimaging and neurophysiologic techniques. ResultsAdaptations within the motor cortices, corticospinal tract, and motoneuron pool are present in those with knee pathology and underline impairments in quadriceps and hamstrings muscle function. Each pathology has evidence of altered motor system excitability and reduced volitional muscle activation and force-generating capacity, but few impairments were common across ACL injury, AKP, and OA studies. These findings underscore the central role of the motor cortex and motor unit behavior in the long-term outcomes of individuals with knee pathology. ConclusionsAdaptations in the efferent pathways underlie persistent muscle dysfunction across three common knee pathologies. This review provides an overview of these changes and summarizes key findings from neurophysiology and neuroimaging studies, offering direction for future research and clinical application in the rehabilitation of joint injuries.

Association of serum and synovial adipokines (chemerin and resistin) with inflammatory markers and ultrasonographic evaluation scores in patients with knee joint osteoarthritis- a pilot study.

Chemerin and resistin are adipokines studied as potential markers for early diagnosis and disease severity in patients with knee osteoarthritis (KOA) Therefore, we aimed to investigate the associations serum and synovial levels of chemerin and resistin with inflammatory parameters and ultrasonographic scores (US) in KOA individuals. Serum was collected from 28 patients with KOA and synovial fluid was obtained from 16 of them. Another 31 age and sex matched cases with no joint disease were included as healthy controls. Concentrations of chemerin, resistin, interleukin-6 (IL-6) and tumor necrosis factor alpha (TNF-alpha) were determined with ELISA. Erythrocyte sedimentation rate (ESR), C-reactive protein, serum uric acid (UA) were measured in the patients group. Participants with KOA underwent US assessment using the Outcome Measures in Rheumatology (OMERACT) scores. Patients with KOA had statistically significant higher level of serum resistin than healthy controls [11.05 (3.78-24.13) ng/mL and 7.23 (3.83-12.19) respectively, p < 0.001]. A strong correlation was found between serum chemerin and ESR (r = 0.434, p = 0.021), uric acid (r = 0.573, p = 0.001) as well as the US (r=-0.872, p < 0.001). Serum resistin demonstrated significant association with TNF-alpha (r = 0.398, p = 0.044). In conclusion, both chemerin and resistin might contribute to inflammatory changes associated with KOA. Further studies are needed to elucidate their potential role in the pathogenesis of the disease.